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Roadmap for Optimising Screening in Australia — Breast

Investigating risk-based breast cancer screening in Australia

Project overview

In May 2018, the Australian Department of Health and Aged Care commissioned Cancer Council Australia to explore options for potential risk-based breast cancer screening in Australia. 

After establishing and consulting a panel of expert advisors, the project, led by A/Prof Carolyn Nickson for the Daffodil Centre, commenced a set of targeted evidence reviews, stakeholder mapping, surveys and engagement, and a mapping of current clinical services and policies, and how people access those services.

In 2019, the project produced a 4–5-year roadmap towards using risk-based population screening to improve early detection of breast cancer in Australia. This set the path for the landmark project Roadmap to Optimising Screening in Australia project (ROSA Breast). 

The ROSA Breast project is the first initiative in Australia to combine evidence reviews, data analysis, population modelling, health service provider surveys, policy analysis and stakeholder engagement to systematically investigate options for risk-based screening in Australian health policy and practice.

Over its four-year timeframe, the ROSA Breast project has submitted eight comprehensive technical reports to the Australian Department of Health and Aged Care, including additional reports in response to the COVID-19 pandemic.

In March 2023, the project finalised a substantial report synthesising all findings to date, with a set of recommended actions and an updated 5-year roadmap designed to guide Australia towards risk-based breast cancer screening.

This submission was carefully prepared with the advice of an independent multidisciplinary Expert Advisory Group, an extensive network of co-opted experts, and input from BreastScreen state and territory senior personnel.

The ROSA Breast Recommendations and Roadmap provide an evidence-based, accelerated path towards risk-based breast screening in Australia. The reports summarise key evidence and areas where the evidence for changes in policy and practice remain inconclusive, provide new modelling and epidemiological analyses to address some key questions, and map the landscape and perspectives of key stakeholders involved in all areas of breast cancer screening and early detection. Breast cancer in Australia has one of the highest survival rates of any cancer yet it is also the fifth leading cause of cancer death.[1] Improved outcomes in early detection through optimal use of current technology and a pathway to rapid translation of new evidence to policy and practice will be key to improving outcomes. With good leadership, resourcing, and coordination across health services and the academic sector, Australia is well-positioned to make this vision a reality.

Explore our Early Detection Policy.